NPI | 1487130050 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 10482) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 10482) |
101Y00000X Counselor | |
Enumeration Date | 2018-07-16 |
Last Update Date | 2021-12-09 |